Shingrix Protects Seniors Better Than Expected

Herpes zoster vaccines, Shingrix and Zostavax put to the test

older couple looking thru binoculars for answers

A new study reported the adjuvant herpes zoster recombinant subunit vaccine, Shingrix, might prevent more cases of herpes zoster than the live attenuated vaccine, Zostavax. 

However, Shingrix might carry a greater adverse event risk at injection sites. 

This study was a systematic review and network meta-analysis comparing the efficacy, effectiveness, and safety of the live attenuated herpes zoster vaccine with the adjuvant recombinant subunit vaccine, placebo, or no vaccine, in those aged 50 years and older. 

The results of this study are as follows: 

  • Network meta-analysis of 5 randomized controlled trials found no statistically significant differences between the live attenuated vaccine and placebo for the incidence of laboratory-confirmed herpes zoster,
  • The adjuvant recombinant subunit vaccine, however, was statistically superior to both the live attenuated vaccine (vaccine efficacy 85%, 95% credible interval 31% to 98%) and placebo (94%, 79% to 98%),
  • Network meta-analysis of 11 randomized controlled trials showed the adjuvant recombinant subunit vaccine to be associated with statistically more adverse events at injection sites than the live attenuated vaccine (relative risk 1.79, 95% credible interval 1.05 to 2.34; risk difference 30%, 95% credible interval 2% to 51%) and placebo (5.63, 3.57 to 7.29 and 53%, 30% to 73%, respectively),
  • Network meta-analysis of 9 randomized controlled trials showed the adjuvant recombinant subunit vaccine to be associated with statistically more systemic adverse events than placebo (2.28, 1.45 to 3.65 and 20%, 6% to 40%, respectively).

Herpes zoster, or shingles, is a neurocutaneous disease that occurs through reactivation of the latent varicella-zoster virus, which causes chicken pox, says the US Centers for Disease Control and Prevention (CDC).

Approximately 25 percent of the population is at risk of developing herpes zoster during their lifetime, and over 60 percent of people with the disease are aged 50 years or older. 

Previously, during February 2018, the American Pharmacist Association published a key difference comparison chart between the two herpes zoster vaccines.

Related herpes zoster vaccine news articles:

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In the USA, vaccination appointments can be scheduled at a local pharmacy at Vax-Before-Travel.

And, vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.

This study was published by The BMJ on October 25, 2018. 

The National Advisory Committee on Immunizations (NACI), which reports to the Public Health Agency of Canada, commissioned this systematic review. 

This study was funded by the Canadian Institutes of Health Research Drug Safety and Effectiveness Network (DNM–137713). ACT is funded by a tier 2 Canada research chair in knowledge synthesis. SES is funded by a tier 1 Canada research chair in knowledge translation. The funder had no input into the study design; collection, analysis, and interpretation of data; writing of the manuscript; and decision to submit the paper for publication. 

All of the authors have no financial relationships with any organizations that might have an interest in the submitted work in the previous three years, and no other relationships or activities to declare that could appear to have influenced the submitted work.